Significant increase in the isolation of glycopeptide-resistant enterococci from patients hospitalized in the transplant surgery ward in 2004-2005

Transplant Proc. 2007 Nov;39(9):2883-5. doi: 10.1016/j.transproceed.2007.08.045.

Abstract

Enterococci despite their low pathogenicity are the third cause of hospital infections. Enterococci resistant to glycopeptides present special risks. The aim of this work was to determine the frequency of isolates of all enterococci versus enterococci resistant to glycopeptides from patients in the Transplant Surgery Ward. Moreover, vancomycin-resistant enterococci (VRE) were characterized with respect to the type of van and ddl genes as well as vancomycin and teicoplanin MIC values. Among 160 enterococcal strains isolated in 2004, only 2 were resistant to glycopeptides (1.3%). In 2005, among 244 enterococci, 44 strains were resistant (18%). All resistant strains were Enterococcus faecium, as confirmed by detection of the ddl gene specific for E. faecium. Moreover, among all enterococci isolated from these patients, E. faecium dominated (over 50% in 5 subsequent years). All examined VRE possessed VanA type of resistance with high vancomycin and teicoplanin MIC values. All of them possessed the vanA ligase gene. The investigated VRE were characterized by high resistance to most antibiotics: penicillin and amoxicillin, rifampicin, ciprofloxacin, and high concentrations of streptomycin, but susceptible to linezolid and quinupristine/dalfopristine. Strains differed in their susceptibility to tetracycline, nitrofurantoin, and high concentrations of gentamicin.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • DNA, Bacterial / genetics
  • DNA, Bacterial / isolation & purification
  • Drug Resistance, Bacterial
  • Enterococcus / drug effects*
  • Enterococcus / isolation & purification
  • Glycopeptides / pharmacology*
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / epidemiology*
  • Hospitalization / statistics & numerical data
  • Humans
  • Poland
  • Transplantation / adverse effects*
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial
  • Glycopeptides
  • Vancomycin